Experts Agree: It’s Time to End Inequities That Impact Education and Health

Terri WrightTerri D. Wright is the director of the newly established Center for School, Health & Education Division of Public Health Policy and Practice at the American Public Health Association. She will provide leadership to the strategic development and integration of public health in school-based health care and education.
She recently retired from the W. K. Kellogg Foundation in Battle Creek, MI where she served for 12 years as a program director for health policy. In that capacity Terri developed and reviewed the Foundation’s health programming priorities and initiatives, evaluated and recommended proposals for funding, and administered projects and initiatives. She also assisted in public policy analysis and related policy program development, as well as provided leadership to the Foundation’s school-based health care policy program.
Previously, Terri was maternal and child health director and bureau chief for Child and Family Services at the Michigan Department of Community Health in Lansing, Michigan. In that role, she managed policy, programs and resources with the goal of reducing preventable maternal, infant, and child morbidity and mortality through policy and programming.
She received her bachelor’s degree in community and school health, as well as her New York State certification in secondary school education from the City University of New York and her master’s of public health degree in health planning and administration from the University of Michigan in Ann Arbor. She is currently a doctoral student in public health at the University of Michigan.
Terri takes an active leadership role in several professional associations and community organizations including the American Public Health Association and the Institute of Medicine’s Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities.

We have a good understanding of why students drop out of high school. But if we know this, why aren’t students succeeding in schools and why aren’t schools succeeding in helping them?

This is one of many vexing questions raised by a panel of experts at the American Public Health Association’s annual meeting. Addressing the dropout crisis, they concurred, requires that we eliminate the disparities that drive both dropout and health inequity.

Students drop out for a host of reasons, many of which tie back to physical and emotional health as well as social conditions such as teen pregnancy, bullying and violence, and the many effects of poverty. Dropping out of high school leads to an unending cycle of adverse effects. Students who don’t graduate are more likely to face health risks, less likely to be employed and insured, and will earn less, all of which contribute to a repeating cycle of poverty.

Reversing this trend demands that our educational system addresses the barriers to health and education that keep students from succeeding. This isn’t a new topic, as those of you who follow this issue or have read our columns here can attest. But it’s far from status quo, which is why we keep examining it from different angles.

At the expert panel, one clear theme emerged: All of us—teachers, administrators, healthcare providers, community members—must work at the “population level,” creating solutions for all students, rather than working only with individuals.

For example, Robert Balfanz, co-director of the Everyone Graduates Center and research scientist at the Center for Social Organization of Schools, challenges education professionals to design learning environments that both meet high educational standards and provide “the right support to the right student at the right time at the scale and intensity required.” As a bright spot, Balfanz cites a field trial with Diplomas Now and three middle schools in high-poverty areas that resulted in better school attendance, better behavior and higher course performance.

It is also important to look at the relationship between health, education and poverty. Charles Basch, professor of health and education at Teachers College, Columbia University, noted that young people who have the most health, academic and economic disparities are all the same population. When we break down the factors that disproportionately affect these students—such as violence, pregnancy, and poor nutrition—we see patterns in their educational experience. We must, says Basch, create programs that address these factors simultaneously instead of individually.

As we address disparities, we must also build pathways to success for students. Ron Walker, executive director of the Coalition of Schools Educating Boys of Color, shared that “coming to school well fed, being able to see, where you can breathe, where you’re able to enjoy physical activity—that’s something that’s not afforded to all of our young people.” In order to see success, he contends that we need to shift the focus away from simply looking at the “common core,” such as academics, and paying more attention to the “uncommon core,” such as health and wellness.

To me, one of the most prominent outcomes from this panel is the consensus that in order to help all students be successful and graduate from high school, we need to broaden the conversation beyond education and health circles. We must approach this as a societal effort. For example, we must look at whether people have access to safe and affordable housing, healthy food, and safe neighborhoods and how those issues play an important role in their overall health. And we must engage others in the conversation, the exploration and the solution.

“Health is advanced when we health professionals are working closely with other people in other sectors of society,” said Howard K. Koh, U.S. Assistant Secretary of Health. “At the end of the day, everything is interconnected, it’s all interrelated, and we all have promises to keep.”

At the center of this connection sit our nation’s school-based health centers. They are the essential link between education and health, providing our students, schools and communities with the appropriate tools and resources they need to be successful. They are proven to improve graduation rates by overcoming health and social barriers to educational success. Now we need more of them, serving more students.

I invite you to join me in this conversation by sharing your perspective in the comments section. Please visit www.schoolbasedhealthcare.org to learn more about the link between education and health and the positive impacts of school-based health centers. Carry this message of equity and opportunity to your work, your elected officials and your community, and define your role in improving graduation rates.